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General NPI Number Information
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NPI Number | 1366528861
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Entity Type | Organization
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Legal Business Name | POST INJURY MEDICAL TREATMENT PC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 17-31 SEAGIRT BLVD
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691
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Country | US
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Telephone | 718-471-3700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 750423 POST INJURY MEDICAL TREATMENT PC
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City | FOREST HILLS
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State | NY
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Zip | 11375
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Country | US
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Telephone | 718-459-5556
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | SHALVA ADAR
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Credential | MD
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Telephone | 718-459-5556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 193766
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License Number State | NY
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